Depression has an impact on disease activity and health-related quality of life in rheumatoid arthritis: A systematic review and meta-analysis.

Publisher: Wiley on behalf of the Asia Pacific League of Associations for Rheumatology Country of Publication: England NLM ID: 101474930 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1756-185X (Electronic) Linking ISSN: 17561841 NLM ISO Abbreviation: Int J Rheum Dis Subsets: MEDLINE

Original Publication: [Oxford, UK] : Wiley on behalf of the Asia Pacific League of Associations for Rheumatology

Affect* ; Quality of Life* ; Surveys and Questionnaires*; Arthralgia/*diagnosis ; Arthritis, Rheumatoid/*diagnosis ; Depression/*diagnosis; Arthralgia/physiopathology ; Arthralgia/psychology ; Arthritis, Rheumatoid/physiopathology ; Arthritis, Rheumatoid/psychology ; Depression/physiopathology ; Depression/psychology ; Disability Evaluation ; Functional Status ; Humans ; Pain Measurement ; Severity of Illness Index

Objective: The aim of this study was to explore the impact of depression on pain, disease activity, functional disability and quality of life in patients with rheumatoid arthritis (RA).
Methods: English (PubMed, the Cochrane Library, Web of Science and PsycINFO) and Chinese (Wan Fang Database and Chinese National Knowledge Infrastructure) databases were systematically and independently searched from their inception until 30 September, 2019. Studies evaluating the impact of depression on pain, disease activity, functional disability and quality of life with the use of the Short Form-36 questionnaire (SF-36) scoring system were included. Statistical analyses were performed with Revman5.3. Data were pooled using a fixed or random-effects model according to heterogeneity.
Results: A total of 7 identified studies matched the inclusion criteria, reporting on a total of 1078 patients with RA in the analysis. The total Disease Activity Score in 28 joints was significantly higher in patients with depression than in patients without depression [standardized mean difference (SMD) =0.47, 95% CI 0.10-0.85, P = .01]. All SF-36 dimensions (physical function, role physical function, emotional role function, vitality, mental health, social function, body pain, general health, physical component scale, mental component scale) were lower in patients with depression than in groups without depression. Interestingly, the results of this meta-analysis showed no significant difference between patients with and without depression in pain (SMD = 0.57, 95% CI - 0.03-1.17, P = .06) and functional disability (SMD = 0.48, 95% CI - 0.03-0.99, P = .43).
Conclusion: This meta-analysis showed that RA patients with depression tended to have higher disease activity and lower quality of life than patients without depression.
(© 2019 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.)

Zhang L, Xia Y, Zhang Q, et al. The correlations of socioeconomic status, disease activity, quality of life, and depression/anxiety in Chinese patients with rheumatoid arthritis. Psychol Health Med. 2017;22:28-36.
Silva CFR, Duarte C, Ferreira RJO, Santos E, da Silva JAP. Depression, disability and sleep disturbance are the main explanatory factors of fatigue in rheumatoid arthritis: a path analysis model. Clin Exp Rheumatol. 2019.
Matcham F, Rayner L, Steer S, Hotopf M. The prevalence of depression in rheumatoid arthritis: a systematic review and meta-analysis. Rheumatology (Oxford). 2013;52:2136-2148.
Zyrianova Y, Kelly BD, Gallagher C, et al. Depression and anxiety in rheumatoid arthritis: the role of perceived social support. Ir J Med Sci. 2006;175:32-36.
Chancay MG, Guendsechadze SN, Blanco I. Types of pain and their psychosocial impact in women with rheumatoid arthritis. Womens Midlife Health. 2019;5:3.
Cheon YH, Lee SG, Kim M, et al. The association of disease activity, pro-inflammatory cytokines, and neurotrophic factors with depression in patients with rheumatoid arthritis. Brain Behav Immun. 2018;73:274-281.
Ji J, Zhang L, Zhang Q, et al. Functional disability associated with disease and quality-of-life parameters in Chinese patients with rheumatoid arthritis. Health Qual Life Outcomes. 2017;15:89.
Mok CC, Lok EY, Cheung EF. Concurrent psychiatric disorders are associated with significantly poorer quality of life in patients with rheumatoid arthritis. Scand J Rheumatol. 2012;41:253-259.
Li L, Cui Y, Chen S, et al. The impact of systemic sclerosis on health-related quality of life assessed by SF-36: a systematic review and meta-analysis. Int J Rheum Dis. 2018;21:1884-1893.
Matcham F, Scott IC, Rayner L, et al. The impact of rheumatoid arthritis on quality-of-life assessed using the SF-36: a systematic review and meta-analysis. Semin Arthritis Rheum. 2014;44:123-130.
Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of Observational Studies in Epidemiology (MOOSE) group. JAMA. 2000;283:2008-2012.
Mata DA, Ramos MA, Bansal N, et al. Prevalence of depression and depressive symptoms among resident physicians: a systematic review and meta-analysis. JAMA. 2015;314:2373-2383.
Zhang L, Fu T, Yin R, Zhang Q, Shen B. Prevalence of depression and anxiety in systemic lupus erythematosus: a systematic review and meta-analysis. BMC Psychiatry. 2017;17:70.
Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557-560.
Sterne JA, Egger M. Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol. 2001;54:1046-1055.
Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629-634.
Uguz F, Akman C, Kucuksarac S, Tufekci O. Anti-tumor necrosis factor-alpha therapy is associated with less frequent mood and anxiety disorders in patients with rheumatoid arthritis. Psychiatry Clin Neurosci. 2009;63:50-55.
Nas K, Sarac AJ, Gur A, et al. Psychological status is associated with health related quality of life in patients with rheumatoid arthritis. J Back Musculoskelet Rehabil. 2011;24:95-100.
Cui X, Wang G, Wei X. The analysis of quality of life and correlation factor about rheumatic arthritis patients. Guide China Med. 2009;7:46-47.
Zhang Y, Ci C, Wang X, Megn S, Su Y. An investigation of depression and related factors in rheumatoid arthritis patients. Acta Acad Med Weifang. 2017;39:233-235.
Chen X, Yang M, Wang T, Fu R, Zeng X. Analysis on depression and the related factors in patients with rheumatoid arthritis. Chin J Clinicians (Electronic Edition). 2013;7:2809-2812.
Matcham F, Ali S, Irving K, Hotopf M, Chalder T. Are depression and anxiety associated with disease activity in rheumatoid arthritis? A prospective study. BMC Musculoskelet Disord. 2016;17:155.
Guo G, Fu T, Yin R, et al. Sleep quality in Chinese patients with rheumatoid arthritis: contributing factors and effects on health-related quality of life. Health Qual Life Outcomes. 2016;14:151.
Zhou B, Li G, Zhang Y, Zhao Z. Effects of nursing interventions on depression of patients with rheumatoid arthritis: a meta-analysis of randomized controlled trials. Arch Psychiatr Nurs. 2016;30:717-721.
Knittle K, Maes S, de Gucht V. Psychological interventions for rheumatoid arthritis: examining the role of self-regulation with a systematic review and meta-analysis of randomized controlled trials. Arthritis Care Res (Hoboken). 2010;62:1460-1472.

71904118 the Chinese National Natural Science Foundation

Keywords: depression; disease activity; meta-analysis; quality of life; rheumatoid arthritis

Date Created: 20191221 Date Completed: 20210111 Latest Revision: 20210111

20240105

10.1111/1756-185X.13774

31858731